OBJECTIVE To investigate the current status,the clinical features and the pathogens of invasive fungal infections in hospital in order to provide clinical treatment based on identification and susceptibility test.METHODS The fungus-cultured positive cases among the discharged patients from Jan 2004 to Nov 2006,were analyzed according to their definite diagnosis of invasive fungal infections under the items,such as the patients age,underlying disease,sample,strain,and species distribution.RESULTS The rates of invasive fungal infections were 4.26%.There were 2221 fungus strains belonged to 8 species in all samples;the patients age was 7-96 years with 2 kinds of various underlying diseases;the age of 2221 cases was 60 years old,mainly senile patients with various diseases accounted for 68.29%.Lower respiratory tract was the most frequent infection site.The main pathogens of invasive fungal infections were Candida spp(93.38%).Strains of Candida albicans were the most frequent organism isolated accounted for 66.19% of all the isolates.C.glabrata,C.krusei and C.tropicalis accounted for 9.19%,8.10% and 4.50%,respectively,the others accounted for only 6.32%.The main infected sites were lower respirtory tract,urinary tract and digestive tract.CONCLUSIONS Candida spp are still the main pathogens of invasive fungal infections.The epidemiological properties of invasive fungal infections is changed.The incidence of non-C.albicans and the Aspergillus strains that arouse invasive infections is increasing recently.

Objective To observe the therapeutic effects and assess the feasibility of radiofrequency thermo- coagulation denervation(TRD)mediated by digital subtraction angiography(DSA)for patients with lumbar facet joint syndrome(LFJS).Methods Eighty LFJS patients were randomly divided into two groups:a denervated group(groupⅠ)and a control group (groupⅡ).The lumbar facet joints of the patients in groupⅠwere treated with TRD,while those in groupⅡhad their lumbar facet joint cavities injected with the mixture of 1 mg betamethasone and 1 ml lidocaine.All patients were assessed using the Visual Analog Scale(VAS)before treatment and 30 rain,1 d, 1 w,1 m and 6 m after.Schober values were measured at 1 w,1 m and 6 m after treatment.The therapeutic effects and side effects were assessed at 6 m after treatment.Results VAS scores in groupsⅠandⅡat 30 min,1 d,1 w and 1 m after treatment were remarkably lower than before treatment.In addition,those in groupⅠ6m after treatment were also significantly lower(P＜0.01).Compared with those in the groupⅡ,VAS scores in groupⅠwere signifi- cantly decreased at 1 m and 6 m after treatment(P＜0.05 and P＜0.01,respectively).The schober values in groupⅠat 1 m and 6m were obviously increased in comparison with those in groupⅡ,while the therapeutic effects in groupⅠat 6m after treatment were better than those in groupⅡ(P＜0.01).There were no side effects,such as injuries to the nerve roots or dysfunctional dermal sensation,in either group.Conclusion TRD,mediated by DSA,has ther- apeutic effects on LFJS.Such treatment is safe,convenient,and gives long-term pain relief.

Chongqing Medical University selected some five-year clinical medical undergradu-ates to set up the pilot class which was called 'clinician excellent class' and implemented the 'organ-systems-based curriculum' (OSBC) integration teaching reform on them. The OSBC teaching of the cardiovascular system breaks the traditional pattern, and carries on the comprehensive reorganization to the curriculum contents and the teaching personnel, and emphasizes the collective preparation, the new teaching method and the reasonable evaluation system. Although OSBC teaching of the cardiovas-cular system has made some achievements, but there are still many deficiencies need to reflect on and improve.

The inflammation factors and roles of them in acute coronary syndrome (ACS) were explored. The similarity between the theory of pathogenic toxin in Chinese Medicine and the inflammation response theory in ACS was discussed. The exploration of new inflammatory factors may be helpful for Chinese Medicine in the research of ACS.
Acute Coronary Syndrome ; complications ; diagnosis ; prevention & control ; therapy ; Humans ; Inflammation ; complications ; etiology ; pathology ; therapy ; Inflammation Mediators ; physiology ; Medicine, Chinese Traditional ; Prognosis ; Toxins, Biological ; adverse effects

Acute Disease ; Adult ; Chromatography, Gas ; Female ; Humans ; Lung ; chemistry ; Phosphines ; analysis ; blood ; poisoning

Objective To explore the relationship between ERG4 gene overexpression and azole resistance in clinical Candida albicans strains. Methods The National Committee for Clinical Laboratory Standards (NCCLS)M27-A2 broth microdilution method was conducted to evaluate antifungal susceptibility of 34 clinical Candida albicans isolates in vitro. Total RNA was extracted from these Candida albicans strains and transcribed into cDNA. Real-time fluorescence-based quantitative PCR was performed to determine the mRNA expression of ERG4 gene. Statistical analysis was carried out by a two-sample t-test. Results The expression level of ERG4 mRNA was significantly higher in fluconazole-resistant than in -sensitive Candida albicans strains (4.20 ± 2.56 vs. 1.72 ± 1.33, t = 3.99, P < 0.05), higher in itraconazole-resistant than in -sensitive Candida albicans strains (3.60 ± 2.47 vs. 1.66 ± 1.61, t = 3.71, P < 0.05), and higher in voriconazole-resistant than in -sensitive Candida albicans strains (3.99 ± 2.72 vs. 2.07 ± 1.58, t = 2.91, P <0.05). Further more, increased ERG4 mRNA expression was also observed in isolates cross-resistant to all the three azole antifungal agents compared with those susceptible to all of them (4.49 ± 2.73 vs. 1.69 ± 1.82, t = 3.81, P < 0.05). Conclusions The overexpression of ERG4 gene may be associated with cross resistance to fluconazole, itraconazole and voriconazole in clinical Candida albicans strains, but its exact role is expected to be investigated through downregulation of the ERG4 gene.

Objective To investigate the epidemiology and relevant risk factors of invasive fungal infection (IFI) in hospital old patients for non-respiratory tract. Methods Seventy-eight patients of IFI in non-respiratory tract were enrolled in this investigation. The incidence and risk factors of IFI were analyzed by prospective case-control study. Results In 78 old patients, 84 strains were isolated from different parts, and the most was Candida spp 82 strains (97.62%,82/84), followed by Candida albicans 55 strains (67.07%,55/82), Candida glabrata 13 strains ( 15.85%, 13/82), Candida krusei 6 strains (7.32%, 6/82), Candida tropicalis 4 strains (4.88% ,4/82), Candida parapsilosis 3 strains (3.66% ,3/82), Candida lusitaniae 1 strain ( 1.22%, 1/82). Aspergillus 2 strains (2.38%,2/84). Multivariate Logistic regression analysis showed that age, pathogen detection time, underlaying disease,glucocorticoids, immunosuppressants were the risk factors for IFI in non-respiratory tract. Conclusions Candida albicans is the main pathogens of Candida infections in old patients. To efficiently control the risk factors should be emphasized in old patients, including early diagnosis and treatment underlying diseases, appropriate use drugs, right to shorten hospital stay.

ion sections were not significantly different between 2005 and 2006, the rest inter-annual comparisons were significantly different (P<0.01).

Objective To investigate the etiology features and relevant risk factors of non-albicans candida infections in hospital. Methods 256 patients of non-albicans candida infections admitted in the second hospital of shanxi medical university from April 2006 to March 2008 were enrolled in this investigation, and a prospective case-control study was executed on 256 cases of non-albicans candida infections and 1220 cases of non-fungal infections. The incidence and risk factors of non-albicans candida infections were analyzed by statistical software SPSS13.0. Results Candida glabrata was the most common reason of non - albicans candida infections (38. 28% ) , followed by candida krusei (37. 11% ), candida parapsilosis ( 12. 50% ), candida tropicalis (9. 77% ), candida lusitaniae (2. 34% ). Univariate analysis and multivariate logistic regression analysis showed that aging, length of stay, underlying disease, losing albumin, using prophylaxis antifungal drugs, using broad spectrum antibiotics, invasive examination and treatment ( such as total parenteral nutrition ( TPN ), invasive procedures, central venous catheters, hemodialysis and mechanical ventilation,et al. ) were the independent risk factors for non-albicans candida infections. Conclusions Non-albicans candida was the main of fungal infections in patients. To efficiently control the disease, it will be helpful by early diagnosis and treatment underlying diseases and commodities and using appropriate tools of examine and treatment methods.

Objective The aim of this study was to investigate the diagnostic impact of polymerase chain reaction (PCR) assays for fungal pathogens in fluid samples,and to evaluate the feasibility of fast PCR diagnostic method for the invasive fungal infection.Methods The sterility body fluid samples from 60 cases hospitalized immunocompromised patients with clinical underlying diseases and suspect of invasive infections with fungi between January 2008 and December 2011 were processed for microscopy and cultures.Applying fungal ITS4 and ITS86 universal primers to amplify pathogenic fungi genes from the sterility body fluid with method of rapid PCR.The results were compared between the standard and PCR methods.Results Humoral direct clinical specimens by PCR amplification of DNA fragments with the scan results were similar.Positive rate of PCR test with clinical body fluid samples and the traditional fungal cultivation was similar.There was no significant statistical difference [38.3％ (23/60) vs 33.3％ (20/60),P ＞ 0.05].Conclusions PCR test is feasibility with clinical fungal diagnosis from directly humoral specimens.To amplify the clinical sterility body fluid samples with ITS fungal universal primers and PCR method might provide an accurate and rapid approach to detect the pathogenic fungi.Its methods on early diagnosis and prognosis of invasive fungal infections are of guiding significance.